Authors: (including presenting author): :
CHENG K(1), CHAN SP(1), CHAN HW(1), CHIU YS(1), LEE HK(1), LI SC(1), NG KY(1), TAI YF(1), TUNG KL(1)
Affiliation: :
(1) Cardiovascular Catheterization & Interventional Centre, United Christian Hospital
Keyword 1: :
Task sharing
Keyword 2: :
Task shifting
Keyword 3: :
Healthy workplace
Keyword 4: :
Psychological well-being
Keyword 5: :
PCA empowerment
Keyword 6: :
Cardiac Catheterization Laboratory
Introduction: :
Cardiovascular Catheterization and Interventional Centre (CCIC) has undergone rapid evolution, characterized by rapid technological advancement and increasing service demand. Nurses in these settings are required to manage high patient acuity while simultaneously performing a wide range of technical, procedural and monitoring tasks. Mismatch between workload and specialized nursing manpower has contributing to professional burnout and potential risks to patient safety. To address these challenges, workforce redesign through task-shifting has emerged as a viable international strategy. "STEP-UP" (Skill Transfer and Empowerment of PCAs) program was developed to explore the feasibility of delegating routine tasks to trained Patient Care Assistants (PCAs), which were traditionally performed by CCIC nurses.
Objectives: :
This project aimed to: (1) Evaluate the operational efficiency and clinical safety of a structured task-shifting enhancement program; (2) Assess the impact on the workload and job satisfaction of CCIC nursing staff; and (3) Determine the technical competency and self-efficacy among trained PCAs.
Methodology: :
A Continuous Quality Improvement (CQI) project was conducted in the CCIC of United Christian Hospital from January to December 2025. Four PCAs and four registered nurses were recruited under the purposive sampling approach. Intervention consisted of a structured PCAs training program targeting two specific tasks: (1) Standardized preparation of a sterile procedural trolley and (2) Assist with femoral access site hemostasis by C-clamp. Outcome measures included: (a) Time required for procedural trolley preparation; (b) Post-C-clamp related wound complication rates; and (c) Assessment of staff perception using tailored questionnaires for nurses and PCAs.
Result & Outcome: :
STEP-UP program demonstrated a significant operational gain, with trained PCAs achieving a shorter time (i.e. 18%) than nurses in trolley preparation (PCAs: 211.5seconds vs. Nurses: 256.8seconds). Clinical safety was remained consistently at a high standard, evidenced by no cases of post-C-clamp related wound complications (i.e. 0%), such as active bleeding and hematoma. All nurses have reported reduced workload and work-related stress and expressed satisfaction with task-shifting strategy. While PCAs demonstrated an enhanced sense of professional integration and excellent compliance with safety protocols. All were aware of their responsibility to immediately report abnormal cases. These outcomes suggest that strategic task-shifting has significantly optimized workflow, maintained patient safety and mitigated nurse burnout meanwhile can support the professional integration of PCAs to achieve long-term workforce sustainability.
